Early Initiation of Evolocumab Treatment in Chinese Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

Zhang, Yahao; Zhang, Yanghui; Zhang, Bin; Chen, Zheng; Wei, Yongjie; Chen, Penglei; Chang, Chao; Liu, Guizhi; Chen, Kui; Ding, Jiandong; Jiang, Zhengming

doi:10.1016/j.clinthera.2022.04.010

Cited by 7 publications

(3 citation statements)

References 29 publications

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“…The definition of "good prognosis" consisted of those with successful thrombolysis or percutaneous coronary intervention (PCI) and transferred to the general ward. The standard of successful thrombolysis and PCI were consistent with the latest guidelines and research results [Sibbing 2017;Zhang 2019].…”

Section: Participants and Study Designsupporting

confidence: 65%

Risk Factors for Poor Prognosis in Acute Coronary Syndrome Admitted in the Emergency Department: A Retrospective Cohort Study

Chen

Wang

et al. 2023

HSF

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Background: In the present study, we aimed to identify risk factors of poor prognosis for patients with acute coronary syndrome in the emergency department. Methods: The study included 2667 patients, who were admitted to the Emergency Department of Chest Pain Center, Fujian Provincial Hospital, due to chest pain from January 1, 2017 to March 31, 2020. Logistic regression was used to identify factors of poor prognosis for patients with ACS in the ED. Receiver operating characteristic (ROC) curve was plotted to assess the performance of the multivariate logistic regression model. Subgroup analysis was used to analyze the difference of SBP in ACS patients with different characteristics. Results: The final analysis included 2667 patients, of whom 2,057 patients (77.8%) had poor prognosis. STEMI (compared with UA) (OR=20.139; 95% CI:12.448-32.581; P < 0.001), NSTEMI (compared with UA) (OR=7.430; 95% CI:5.159-10.700; P < 0.001), respiratory rate ≥20 bpm (compared with <20 bpm) (OR=1.334; 95% CI: 1.060-1.679; P = 0.014), and use of antiplatelets (OR=1.557; 95% CI:1.181-2.053; P = 0.002) was associated with increased likelihood of poor prognosis for ACS patients in ED. SBP ≥140 mmHg (compared with<140mmHg) (OR=0.574; 95% CI: 0.477-0.690; P < 0.001) was associated with decreased likelihood of poor prognosis for ACS patients in the ED. The area under curve (AUC) of the predictive efficacy of logistic regression model was 0.825 (95% CI: 0.795-0.833, P < 0.001). Conclusion: This study found that STEMI, NSTEMI, respiratory rate ≥20 bpm, and use of antiplatelets were associated with increased likelihood of poor prognosis for ACS patients in the ED. It also found that SBP≥140 was associated with decreased likelihood of poor prognosis. Our study may be useful for doctors to make clinical decisions for ACS patients.

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Section: Participants and Study Designsupporting

confidence: 65%

Risk Factors for Poor Prognosis in Acute Coronary Syndrome Admitted in the Emergency Department: A Retrospective Cohort Study

Chen

Wang

et al. 2023

HSF

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“…Very recently, the feasibility and safety of the early treatment of mAbs anti PCSK9 in lipid-lowering therapy has been investigated in patients with extremely high cardiovascular risk with LDL-C levels ≥ 3.0 mmol/l. The results indicated that evolocumab can reduce the cumulative incidence of cardiovascular events as early as 20 days after the initiation of the treatment without increasing adverse reactions [85]. Nevertheless, these results required further confirmatory studies with larger patient population.…”

Section: Clinical Evidence Supporting the Use Of Mabs Anti Pcsk9 In A...mentioning

confidence: 88%

Pharmacological rationale for the very early treatment of acute coronary syndrome with monoclonal antibodies anti-PCSK9

Ferri

Ruscica

Lupo

et al. 2022

Pharmacological Research

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“…Evolocumab/matching placebo 3.00 I, II, III, IV, V, Unclear RCT Zhang et al [34] prognosis compared with the placebo group. Improvements were primarily observed in the reduction of MACE, nonfatal myocardial infarction, cardiovascular death, stroke events, hospitalization for recurrent ACS, and the need for coronary revascularization.…”

Section: Furtadomentioning

confidence: 99%

The benefits of PCSK9 inhibitors in patients with acute coronary syndrome: a systematic review and meta-analysis

Zhang,

Chang,

Zhao

et al. 2024

Emerg Crit Care Med

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Background Proprotein convertase subtilisin/kexin 9 (PSCK9) inhibitors have been beneficial for many patients with hyperlipidemia. The objective of this study was to investigate the benefit of PSCK9 inhibitors in patients with acute coronary syndrome (ACS). Methods We systematically searched PubMed, EMBASE, and Cochrane Clinical Trials (published before January 2023; no language restriction) to compare the treatment of patients with ACS using PCSK9 inhibitors and placebo. The primary end points were major adverse cardiovascular events, nonfatal myocardial infarction, cardiogenic death, stroke, hospitalization for recurrent ACS, and coronary revascularization. Fixed- or random-effects models were used to assess the aggregated data. Results Of the 1686 identified studies, 5 were eligible and included in our analysis (of a total of 38,005 participants, 18,609 cases were placed in the PCSK9 inhibitor treatment group and 19,396 cases in the placebo group). Compared with the placebo group, PCSK9 inhibitors significantly reduced the major adverse cardiovascular events (odds ratio [OR]: 0.83; 95% confidence interval [CI]: 0.77–0.88; P < 0.00001) for patients following ACS. The incidence of nonfatal myocardial infarction (relative risk: 0.80; 95% CI: 0.74–0.87; P < 0.00001), cardiovascular death (OR: 0.96; 95% CI: 0.83–1.10; P = 0.56), stroke (OR: 0.74; 95% CI: 0.63–0.88; P = 0.0007), hospitalization for recurrent ACS (OR: 0.57; 95% CI: 0.40–0.83; P = 0.003), or coronary revascularization (OR: 0.82; 95% CI: 0.76–0.88; P < 0.00001) all demonstrated a significant decrease in the comparison between the 2 groups. Conclusion This meta-analysis demonstrated that treatment with PCSK9 inhibitors in patients with ACS reduced the probability of multiple cardiovascular events and improved patient prognosis.

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Early Initiation of Evolocumab Treatment in Chinese Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

Cited by 7 publications

References 29 publications

Risk Factors for Poor Prognosis in Acute Coronary Syndrome Admitted in the Emergency Department: A Retrospective Cohort Study

Risk Factors for Poor Prognosis in Acute Coronary Syndrome Admitted in the Emergency Department: A Retrospective Cohort Study

Pharmacological rationale for the very early treatment of acute coronary syndrome with monoclonal antibodies anti-PCSK9

The benefits of PCSK9 inhibitors in patients with acute coronary syndrome: a systematic review and meta-analysis

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